DERRICK FOWLER LCAS-A NPI 1518369065

NPI Information

NPI: 1518369065
Provider Name: DERRICK FOWLER, LCAS-A
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
650 HIGHLAND AVE STE 100
WINSTON SALEM, NC
ZIP 27101
Phone: (336) 607-8523
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Derrick Fowler, LCAS-A is an addiction (substance use disorder) counselor in Winston Salem, NC. Derrick Fowler, LCAS-A NPI is 1518369065. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

650 HIGHLAND AVE STE 100
WINSTON SALEM, NC
ZIP 27101-304
Phone: (336) 607-8523
Fax: (336) 773-0916

The enumeration date for this NPI number is 9/16/2014 and was last updated on 7/31/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCAS-16	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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